Device in aid of spastics



Dec. 27, 1949 s. v. KOSTER I DEVICE IN AID OF SPASTICS Filed Dec. 22, 1945 INVEN TOR. CFACE VII/[EN KOSTER ATTORNEY Patented Dec. 27, 1949 UNITED STATES PATENT OFFICE 3 Claims.

The present invention relates to improvements in orthopedic appliances and particularly to leg and feet devices for persons, and particularly children suffering from spastic paralysis. It is characteristic of this form of paralysis for the leg muscles to become rigid attended by a heightening of the tendon reflexes, or so-called spasms. This causes the legs and feet to cross involuntarily which condition is commonly known in the medical profession as scissors. As a consequence, when treating such a child, it is necessary to first uncross the legs and feet so that the child can stand, for standing is a prerequisite to walking and normal life. Also as a part of this affliction the tendons of the foot contract causing the foot to be drawn up to the toes. To correct this the foot must be dropped gradually and supported during the entire treatment.

Unless these conditions are remedied by the use of suitable orthopedic appliances, such as the present invention, and proper medical treatment, there is danger that by the time such afilicted child has reached the age of seven the muscles behind the knee are so stiffened that operative measures must be resorted to in order to enable the movement of the foot and knee joints.

Formerly the treatment of spastic paralysis in children required the use of cumbersome plaster casts which caused overheating of the limbs and great discomfort to the patient. The additional physical work involved in taking care of patients in casts greatly increases the labors required for proper care and attention. It is apparent that by incasing the limbs in a cast any desired manipulation or inspection of the affected members is impossible until the cast is removed.

It is therefore an object of the present invention to eliminate the need for such casts in the treatment of spastics by providing a suitable limb spreading appliance to support the limbs and feet of a spastic child and to enable proper orthopedic treatment, with consequent relief and possible eventual recovery of the use of the affected limbs.

A further object of the present invention is to provide a leg spreader and foot support in which provide a longitudinal adjustment to accommodate the lengthening of the limbs during the growth of the child.

A still further object of the present invention is to provide a device of the character described that they be worn without undue discomfort for extended periods of time and allow a controlled amount of voluntary or involuntary movement of the limbs, while at the same time providing a, device which may be removed when the child is to be given manipulation walking exercises or other treatment.

Still another object of the present invention is to provide a corrective device of the character described that may be kept clean and sanitary at all times, thus greatly reducing the labors of those charged with the care of and attendance on the patient.

In cases where a hip joint has been dislocated or injured it is necessary to effect a gradual spreading of the limb or limbs while keeping the limb straight and it may in some cases be advantageous to study the progress of such manipulation by viewing the hip joint through an X-ray or 5 fluoroscopic screen until the hip joint snaps into place.

It is therefore another object of the present invention to provide an orthopedic appliance whereby a medical practitioner may set the hip joints of a patient without undue pain or suffering of the patient, with the added advantage of being able to observe the progress of the treatment through usual means, at all times.

Further objects are to provide a construction of maximum simplicity, economy and ease of manufacture and such further objects, advantages and capabilities as will fully appear and as are inherently possessed by the device and invention described herein.

The invention further resides in the combination, construction and arrangement of parts illustrated in the accompanying drawings, and while there is shown therein a preferred embodiment it is to be understood that the same is illustrative of the invention and that the invention is capable of modification and change and comprehends other details of construction or material without departin from the spirit thereof or the scope of the appended claims.

Referring now to the drawings;

Figure 1 is a perspective view of the device showing a child's legs held in position during treatment.

Figure 2 is a side elevation of the device showing the spreading means in opened position.

'II by riveting or other means.

Figure 3 is a side elevation of a portion of the device showing a modified form of the spreading means and its angular adjustment.

Figure 4 is a fragmentary inside elevation of a portion of one member showing a holding and adjusting means for the foot rest or stirrup and showing a method of effecting the rotational and longitudinal adjustment of the foot rest.

Figure 5 is a horizontal section of the stirrup and adjusting means taken on the line V--V of Figure 4, but with the stirrup turned at a 90 angle.

Figure 6 is a rear elevation of the stirrup removed from the device showing the threaded pin and adjusting holes for positive holding of a setting.

In the drawings like reference numerals have been used to designate corresponding parts in the several views. The device is formed with two legs or principal members consisting of fiat elongated plates is and II, which are preferably 'of light, strong metal but may be of any suitable material which may be available. These members or plates l and II are joined along their corresponding edges at one end by a hinge X l2 which permits them to be separated to effect the spreading of the spastic crossed limbs of a paralyzed child here shown strapped to the device by means of straps 13, one or more sets of which may be attached to each member [0 and The straps [3, or other suitable holding means preferably pass 'on the outside of the inner surfaces of members [0 and H. An adjustable rod generally designated I4, is detachably connected to angular brackets l which are riveted to the lower ends of members It and H. The extendin flange of these angular brackets I5 are drilled for attaching rod I4. Both ends of rod M are flattened and have a hole drilled through their fiattened portion to accommodate a screw I6 which holds both these members securely by means "of a wingnut IT. This also enables the detachment of the rod M which may be a single rod and interchangeable with rods of varying lengths for the different angles of adjustment.

In the preferred form for the wider adjustments shown in Figure 2, the rod M is made in two telescoping sections, l8 and 20. The tubular portion 29 is split and threaded at the free end, and a taper-threaded jam-nut 2! is screwed thereon which clamps the rod portion is firmly in any increment of adjustment at any desired angle, limited by the length of the outer section It is understood that various other devices may be employed to effect this angular adjustment and a modified form is shown in Figure 3. This form comprises two links 22 attached to brackets HS in the manner before described. The links 22 fold over each other and the angle of the members Ill and H may be adjusted and locked by means of a wingnut 23 situated at their central pivoting point. Additional locking for greater rigidity may be secured at brackets l5 by tightening'wingnuts I! which hold the assembly in place.

Because the spastic condition of the paralyzed child also causes the foot tendons to contract, causing the forward part of the foot to be pulled iupwardat the toes, it is necessary to provide an adjustable foot support 24 in which the foot may be held and gradually dropped or moved to a normal position as the condition improves.

Since both members and H and the foot 4 rests 24 areidentical, for sake of simplicity only one of each will here be described.

The foot rest assembly consists of a channel like stirrup 24 suitably shaped in which the childs foot is held by means of straps 25 and 26 attached thereto in any suitable manner. The patient can exert pressure against this stirrup without disturbing the holding or the set position. The foot rest 24 is slidably attached to the outer face of member ID and travels longitudinally in slotted portion 2'! of said member I0.

-On the inner surface of the stirrup 24 is a reinforcing plate 29 on which is mounted a perpendicular threaded stud 28. The stud 28 passes through the slot 21 and acts as a guide or bearing surface for the stirrup 24. On the inner face of the member I!) the stud 28 passes through an eccentric hole 34 in disc 3|. The wingnut 30 on the threaded stud 2B bears against the disc 3! to hold the foot rest assembly firmly in the adjusted longitudinal position. It is necessary to have the longitudinal adjustment to accommodate the growth of the patient during the period during which the treatment must be applied. Obviously it is impossible to accomplish any adjustment in a cast or fixed brace. As before indicated, the foot rest assembly is made to provide rotational adjustment as the foot is gradually dropped to the normal position. The means here shown for this purpose, although any suitable means may be used, is the provision of a series of appropriately spaced holes 33 arranged on the inner surface of plate 29. Disc 3| is provided with an eccentric stud 0r pin 32 diametrically opposite to the hole 34, which passes through the slot 21 and fits within one of the spaced holes 33 for the correct adjustment. When the wingnut 30 is tightened for the longitudinal adjustment the pin 32 holds the stirrup 24 against any possible rotational movement. The pin 32 being eccentric with respect to the hole 34 (and threaded stud 28) gives a second bearing point or guide for the longitudinal travel of the foot rest assembly in the slot 21, thus making possible better longitudinal adjustment' and providing against rotative movement in the locked position. It is apparent that the arrangement of the spaced holes 33 provide for holding in any angle desired and in small enough increments for gradual correction.

A plurality of buckled straps 25 and 26 are attached to the stirrup 24 in any suitable manner to hold the foot in the proper position in the stirrup. One strap may pass around the heel and the other over the foot as shown in Figure 1. A soft pad 35 is preferably attached to the stirrup 24 and placed over the child's foot before the straps 25 and 26 are adjusted in position to provide comfort and insulate the foot from the heat exchange relation with the material of the device.

The members l0 and II are similarly provided with a soft pad or cushion 36 which may be of waterproof and washable material or may have such a covering over soft padding. Also, to provide comfort and eliminate chafing, the straps l3 are preferably lined or provided with soft pads 31.

The manner of using the device has been explained in the course of the description but the device should not be used except under medical supervision. I I

I claim: v

1. A device for treating spastic paralysis comprising in combination a pair of human limb supporting members, pivoting means at one'end of and joining said members, means for attaching said members to said limbs, adjustable spreading means at the opposite ends of said members, locking means for said spreading means to maintain any desired angle of spread and a foot support on each of said members adapted to hold a human foot in a predetermined relation to said members.

2. An orthopedic instrument for treatment of spastic paralysis comprising in combination a pair of leg supporting members adapted to be attached to a spastic persons leg, hinge means joining said members at one end, an adjustable connection at the opposite ends of said members for adjusting the distances between the unjoined ends, locking means for said connection at any desired angle, foot supports, adjustable both longitudinally and rotatably, attached to said members and means for locking said foot supports in the adjusted position.

3. An orthopedic appliance comprising in combination a pair of spastic limb supporting members, a pivotable connection between said members joining them at one end thereof, strap means to hold the limbs of a patient to said members,

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 1,562,150 Denton Nov. 17, 1925 1,955,017 Rankin Apr. 17, 1934 OTHER REFERENCES Ponseti, Ignacio, Journal of Bone and Joint Surgery, 0ctober 1944, p. 790. 

